


Underneath

by Ranowa



Category: Sherlock (TV)
Genre: FTM Sherlock Holmes, Gen, Hiding Medical Issues, John Watson is a Good Doctor, John Watson is a Good Friend, Medical Conditions, Mycroft Being a Good Brother, Prompt Fic, Sickfic, Trans Sherlock Holmes, Transphobia
Language: English
Status: Completed
Published: 2020-06-17
Updated: 2020-06-21
Packaged: 2021-03-03 22:21:26
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 3
Words: 13,136
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/24773053
Author URL: https://archiveofourown.org/users/Ranowa/pseuds/Ranowa
Summary: When John comes home to find his flatmate curled on the floor of the loo and covered in blood, the explanation is not at all what he was expecting.
Relationships: Sherlock Holmes & John Watson
Comments: 16
Kudos: 249





	1. Chapter 1

**Author's Note:**

> So. My computer completely ate the first draft of this! Which was fun :D
> 
> This was actually a suggestion from a friend of mine, who wishes to remain anonymous, and it's something I've been working on for quite a while. It's pretty far out of my usual comfort zones, but I do have irl experience with some parts of it (though a complete dearth of experience with others). Because of this, and it's such a sensitive topic, I tried to tag the warnings appropriately, but I really don't know what the norm for warnings here is. If anyone thinks one is missing that would be appropriate or helpful for readers who want to avoid content like this, do please let me know :)

John got home to an empty flat.

The sitting room was empty, barren of any signs of intelligent life. A nest of blankets settled on the couch, their center empty save for a mound of equally fluffy pillows, and there was a mug on the floor, but those were the only signs that Sherlock had even been here at all today.

Wherever he was now, though, it certainly wasn't here.

And that only meant one thing.

"Oh, thank _god,"_ John said to the empty space, and grinned ear to ear.

This was going to be the best night he had had in _days._

Sherlock had been having one of _those_ weeks, again. The sort that made John feel as if he lived with a hormonal teenage girl, instead of a full grown man(-child). Snipping, sulking, pouting, and yelling; all the way to the level of a tantrum. Last night, he'd pushed a mug onto the floor, seemingly just to see it break. Then he'd sat there glowering at the mess as if it had personally offended him. John had made the terrible mistake of telling him to clean it up, and been immediately shouted at to shut up, make himself useful, and _go away._

A night to himself, wherever Sherlock was, and whatever the hell he was up to, was really for the best. Best friend or not, if Sherlock had been here now, and still in the same mood he'd been in this morning, then John really might have ended tonight by strangling him.

The worst part of it was, he knew what was wrong.

Sherlock Holmes was sick.

Not that he would ever admit that; god, no. Not before hell itself froze over. Not with anything serious, either. John suspected the head-cold that was working its way around London- it'd have been enough to make anybody cranky, and Sherlock was not just _anybody._ Sherlock had spent the past several days alternatively wolfing down Mrs. Hudson's food like a hungry dog, sulking about like John had kicked his puppy, pouting into the back of the couch, and in general complaining that the universe ought to implode, and still, John hadn't figured out until this very morning, when Sherlock had- get this- _slept in._

And it wasn't even the day after a case!

The man was definitely sick, whether Sherlock even realised it or not. And what he needed, rather than an all-nighter on a case, was a night in, with tea, blankets, and crap telly. It was just what the doctor ordered.

John just wasn't insane enough to think that that would be a winning argument on Sherlock. Ever.

At this point, all he could hope for was for the whatever had Sherlock so under the weather to hit hard and fast, and turn him into a tissue-infested feverish ball of blankets. Get it over with, sweat it out, and John could alternately make him tea and inform him that _this_ was why you _listened_ to your doctor when you took a swan dive into the Thames after a suspect and then refused to so much as let anyone listen to your breath sounds.

But for tonight, he had tea, and just being delivered takeaway, and _peace and quiet._

And he was going to enjoy it.

Three bites into Chinese takeaway, peace, and quiet, someone threw up.

Someone threw up, very loudly, painfully, and unmistakably, from the loo, just three feet away.

Oh, no.

John closed his eyes, clasping his fingers together, and let out the longest, most exhausted sigh of his life. He counted to ten, and spent those very important seconds saying goodbye to the rest of his night.

Then, he dragged himself up to his feet, and turned to face the music.

"Sherlock?"

The sounds stopped. The heavy breathing did not. Worry caught in John's throat.

He'd been home almost half an hour, now. Had Sherlock been in there this whole time?

"Sherlock," he called again, "are you-"

"Fine." His flatemate's voice was muffled, a low and wrecked growl; the sound of someone who had been vomiting without water for a while, now. "Get rid of your dinner and leave me alone."

"My dinner?"

"Lo mein!" Sherlock snarled, his voice cracked. "Sweet and sour chicken, lo mein, and a disgusting amount of soy sauce, I can smell it and it's _horrid,_ _get rid of it_ and _go away!"_

Was _that_ why he had thrown up? Never mind that John was certain Sherlock could not smell soy sauce from that far away- he'd gotten his order right, and that was enough for John to pull a retreat and quickly stow the containers in the fridge.

Then, back to the loo.

He could follow the first command, but he wasn't going to follow the second.

"Sherlock, are you okay?"

No answer. Eh, he could hear this one on his own, thanks, no need for Sherlock to say it aloud. _Obviously not, John. Use your senses! And then go away._

He tried again. "Do you have a fever?"

No answer. He'd take that as a yes, then.

"What about water? If you're throwing up, you need to stay hydrated."

The detective stayed silent again, just for a moment. Then: "John, _please_ go away."

His stomach lurched. Sherlock sounded _awful._ His voice was low and in pain, barely more than a choked whimper, and even worse than that, he sounded desperate. Desperate to get John to leave him alone.

Sherlock usually wasn't shy about being sick. Quite the opposite; a sick Sherlock was a whiny, over-dramatic attention hog, a little sniffle turned about to demand John as his personal, bedside, tea-fetching physician, on call to prevent death twenty four hours a day.

Putting his concern and confusion aside, for the moment, John trudged back to the kitchen to fetch a glass of water. "Look, I'm sorry you're feeling poorly, and I'll leave you alone if you want. But first, you need-"

"Stop it! John-" His voice hitched higher, close to panic. "Just give me- I'm... I'm not dressed!"

Now he was just being ridiculous. "Sherlock, I'm a doctor. I've seen way worse, and what's more, I've seen way worse from _you._ Stop wearing a sheet around the flat, and I'm coming in."

He pushed open the door, and almost dropped the glass.

"Oh my god-"

"Stop it, John," Sherlock whined, looking distinctly miserable and defeated. Whatever fight had been in his voice from outside the door, it was all already gone. "I'm fine-"

"You are _not fine!"_

Sherlock was stretched out on the floor, all long and loose limbs entangled in towels and sweat and blood. Sherlock was _bleeding._ He couldn't tell from where, but wet smudges were on his face, his hands, his stomach, and the messy sprawl of towels about him was stained, too, and it became very clear when John tried to reach for him that the towels were all he had on. He was milk pale and soaked with sweat and ice-cold, hair still drying from a recent shower, and his piercing eyes squeezed shut in anguished defeat.

Sherlock had been lying in here, bleeding, for half an hour. _At least._ Definitely not a severe bleed, but he was still bleeding, and he looked absolutely dreadful. "Come on, Sherlock, talk to me-" John reached for for the lowest towel, his mind racing. Where the hell had he run off and gotten himself hurt?! This morning, he hadn't even had a case!

He got no further than lifting the towel one inch away before Sherlock smacked him straight off.

"Sherlock! What's gotten into you?!"

"Stop it," he croaked. "J-just... _stop it_ , John."

He wouldn't look him in the eye. He wouldn't even open his own eyes at all, his face still turned severely away, so shrunken and small and... and _defeated_. The look on his face was pure _agony,_ and if Sherlock had been anywhere but sagged on the floor, slick with blood from an unknown source, that would've been enough to make John give in. He had _never_ seen Sherlock look like this before, and he never wanted to see him look like it again.

But he was bleeding, and John _was_ his doctor.

"Listen to me," he snapped, and then snapped his fingers, too, right over his face. "I will take care of you, whatever this is, but you have to let me." Sherlock wasn't typically shy about injury, either, but he was naked, and the stains of the blood suggested the injury was underneath the towel wrapped around his waist. Granted, modesty and Sherlock Holmes really didn't belong in the same sentence, either, but...

"Sherlock," he tried again. "Whatever it is, I can promise I've seen worse, but if you don't allow me to see, I _will_ call you an ambulance right now."

The detective inhaled in, starting to talk, but a sharp whimper pierced his voice and suffocated him straight back into silence. He shook his head, craning away from John's hand, his arms wrapping around his stomach, and John nearly went for his phone right then and there. Something was _wrong,_ and if Sherlock was in this much pain, it almost definitely needed treatment beyond a paracetamol and a heating pad.

"...it's normal. It's a..." Sherlock swallowed, his throat spasming. He _still_ would not meet John's eyes, so uncharacteristic it made his stomach drop. He looked like he wanted to melt into the floor. "It's a medical condition, John. I'll be fine."

Oh, _please._ "There is no medical condition that would give you spontaneous bleeding and pain this severe and not require immediate treatment."

But his friend merely shrank further away, clutching his towels like a lifeline. Blood smeared all his fingertips and both his palms, bright red and wet, and the splash pattern of it on his skin was just short of alarming. What the hell had happened here? John tried to free one of the towels again, but even in this state Sherlock's grip was like iron, and the look on his face-

He _really_ didn't want John to see what was under that towel.

"There is a condition. Mycroft... text Mycroft, ask him, just _leave me alone,_ John, _John-"_ He hissed through gritted teeth, jaw clenched and throat jumping and, oh, god, he was _crying._ His eyes were wet, his face slicked with sweat and blood and fever and now tears-

"Sherlock-"

"There is a condition. One that afflicts approximately fifty percent of the population of London."

"One that..." John stopped, his brow furrowing. "Okay, now you're just being ridiculous. You don't have anything to be embarrassed about, but unless you're trying to tell me you're secretly a woman-"

_"John-"_

John sunk his fingers into the towel, and yanked it free from Sherlock's desperate grip mid-whimper without room for any further delay.

He gaped.

The source of the blood clearly was between his legs. His inner thighs were stained the worst, even squeezed tightly together as he fought to hide, to squirm away from John, but curled up there on the floor, cold, exposed, and bare, there was nowhere to hide. Hide his- utter lack of a penis.

He was bleeding from his genitalia.

His _female_ genitalia.

Numbness settled in his throat.

"Sher... Sherlock..."

Sherlock's clawed grip on his wrist fell, dropping down to the floor to curl hopelessly back around his stomach. The look on his face was the sheer personification of defeat.

Without a word, Sherlock snatched his other towel downward, lowering it from his chest to wrap around his waist instead. The one John had grabbed slipped from numb fingers, pooling over Sherlock's thighs, but the detective stayed with his head turned away and his jaw clenched tight and his knuckles bone-white.

As utterly thunderstruck as John was, he couldn't stop himself from staring at Sherlock's chest, now. His narrow, bony chest, with two very distinctive scars.

"You're-..."

"-transgender," Sherlock finished, and that final word, he spat as if it were an oath so foul it made him sick just to have it in his mouth.

Seconds ticked by in silence.

John continued to gape.

"Well, then," Sherlock said flatly, when John did not go on. "If you've an apoplectic fit scheduled, then I invite you to hold it in the sitting room. Because, as you can see, I'm in a fantastic amount of pain, and somewhat lacking in the ability to handhold you through at the present time."

John had no idea what to say.

Looking down at Sherlock then, then, down on his knees on the floor and staring at the consultant, all that could really make it through his current haze was how... _pitiful_ he looked. It struck him in a gut punch, but god, it was true- that was Sherlock Holmes, and there was no other word for it. He looked pitiful. So slumped and defeated and pale, one arm still wrapped about his stomach in sheer misery while the other draped over his face, shrouding it from view, his each and every breath short and painful. It felt like he was witnessing something intensely personal and intimate, suddenly, and- _wasn't he?_ Sherlock, naked and smeared with blood and sick, curled up on the bathroom floor. He had explicitly and expressly wanted John to go. He had _told him_ to leave, but John hadn't listened, and he couldn't take that back. He couldn't take this back.

John sat there, still thunderstruck and limp, and he looked down at his stricken and furious friend, and all he knew was that he only had one chance to do this right.

Oh, god.

Okay. This was- okay. John took in a deep breath, slowly, in and out, willing down the numb squirming in his stomach, the dumbstruck shock flooded through every bit of the rest of him. Okay. The rest of him was too shocked to function, so he was left to just default down to his medical training. Yes. He could do this. Transgender patient: severe menstrual pain, vomiting, fever. Simple. Textbook, even. Sort of. It was- oh, fucking hell-

"Okay," John said aloud, scrubbing a hand over his face. Sherlock still wasn't looking at him, eyes shut and expression pinched, and after a moment of thought, he settled a hand down on one achingly thin shoulder. "Just- taking a step back, for a moment. Okay."

Sherlock still did not look at him, piercing eyes fluttering. For once, John couldn't blame him.

He'd _really_ messed this one up.

"Sherlock." He rubbed his shoulder, but it felt distinctly uncomfortable and awkward, and Sherlock looked so miserable he shot his hand back to himself. "Everything- everything else aside."

He'd hoped no longer touching him would make him stop looking so... _like that._ The ice-cold anger across his shadowed face right now did not look as if John had been all that successful.

_Come on, Dr. Watson. Just a patient. Just a standard patient. That's all._

"This level of pain isn't normal, Sherlock, and neither is being this ill-"

"It is for me."

"I really think you should get-"

"I've _been_ to A&E, John!" Sherlock cried, and his next attempt to reach for him got his hand smacked like a buzzing mosquito. "I've been twice! I'm _not_ crawling into a cab just to have an ultrasound shoved up inside me, wind up being told there's _nothing wrong with me,_ and to either deal with it or seek my morphine elsewhere!"

As if on cue, Sherlock then shot up from the floor, hurtled upwards to clutch the toilet, and threw up for the second time.

John winced in horrified sympathy. He opened his mouth to say something, _anything,_ but the shock swelled in his throat and he could do nothing at all but just rest a hand on his lower back, running it up and down with each shuddering heave.

Sherlock continued making those horrible noises, and John felt about as useful as a lump of wet clay.

He remained adamant that Sherlock should see a doctor, but Sherlock clearly did not want to go, and for once John was hesitant about overruling him. He was obviously in too much pain to walk, and too sick to have a cab stop for them- they'd have to call an ambulance or one of Mycroft's cars, and even then, what would A&E even be able to do? Once they'd ruled out something urgent, like appendicitis, they'd just send him back home with NSAIDs and a referral to a specialist. Sherlock had probably already all but overdosed on every NSAID in the flat.

"John..."

John started back into the room, discomfort still lodged in his throat. "Yeah," he assured, rubbing his back again. "Yes?"

Sherlock's grey eyes were half-lidded and wet, watering in unadulterated misery. He didn't follow it up with anything, just his name, but the way he was looking at John- he was waiting for something, he realised. For John to do something. He waiting to see what John would do.

Well, so was John.

He had to do this right. He had a hundred questions, and he felt betrayed and shocked and dumbstruck and had no idea what to do, and really just wanted to go lay down for a bit with a stiff drink, to be quite honest- but the look on Sherlock's face said he had to do this now. He had one chance to handle this right.

"...Okay," John landed on, finally. Sherlock seemed done throwing up, for the moment, so he helped his friend back to lying down in his nest of towels. "Sherlock, how bad is the pain right now, on a scale of one to ten?"

A moment passed in silence. The detective worked his mouth, chalk pale and sweating. "Eight," he croaked. "Appendicitis was a six."

 _Christ._ John squeezed his shoulder again, watching him curl his arms back around his stomach and revert back to his miserable shell. His shoulder and the resultant physical therapy had ranged from a three to a seven. "And it's localized where?"

"Abdomen," Sherlock rasped. He traced on the right side of his stomach- over what he knew to be an appendectomy scar, funnily enough. "Right thigh. Lower back."

That wasn't normal, either. Was it? It had been a long while since gynecology- _hell._ Just the combination of Sherlock and _gynecology_ in his head, this was too much, what the hell was he supposed to say-?

"Well... at least we know it's not your appendix, mate."

Sherlock managed a wry smile back. But it was a near thing, and it crumbled back into a flat line of misery all but immediately.

"Already've taken a double dose of paracetamol," Sherlock went on, eyes half-lidded. "Fucking sugar pills."

"You shouldn't h-"

"Oh, shut _up,_ John!"

The detective lapsed back into silence after that, shivering madly and his face stricken, and John let him. He now wanted to take Sherlock into A&E even more than before, he wanted to call Mycroft and get a car down here right _now,_ even if the only treatment he could have was IV morphine and overnight observation. This was not normal, throwing up from pain was _not_ acceptable, not for John's best friend.

But this was clearly not Sherlock's first rodeo. And if Sherlock didn't want to go this badly, then John really didn't feel right about forcing it.

After all- he wasn't really Sherlock's doctor, was he?

He'd thought he was. And he was pretty sure Sherlock marked his name down as such on every form that crossed his path.

But if Sherlock actually trusted him as his doctor- as a _friend-_ then this never would've happened.

John settled back down onto his knees, and made his decision.

"All right, Sherlock." He reached back for the glass of water he'd first come in with, what felt like a century ago, now, when Sherlock had just been sick with flu and everything had still fucking made _sense._ "You need to stay hydrated. If you can keep water down then we won't go to hospital, not right now, but at a certain point, we will _have_ to go down there even if I have to call the ambulance myself. Agreed?"

"You're not asking for agreement. You're not giving me a choice."

"You want me to call for an ambulance right now?"

Sherlock groaned mightily, sagged back as limply as a sack. He dropped his arm over his face again, wheezing through his nose, not looking at him again, never looking at him, but his face was again back close to defeat.

It wasn't at all what John had wanted to see.

"Fine," he muttered, huddled back up under his towels like a kicked dog. He didn't shake off John's hand on his shoulder, but he didn't lean into it, either.

He made no move at all to take the water. John wondered if he might not be able to even sit up.

After several minutes, Sherlock's low murmur spoke up again.

"John?"

He rubbed his shoulder again. His skin was cold and wet, and John had to resist the urge to fetch a third towel. "Yeah?"

He thought Sherlock might be trying to broach the earlier bombshell. For a moment, he looked as if he actually would, his throat moving in a low and gravelly cough and his eyes clouded, preparing to speak up, to _explain._ To just open his mouth and be all Sherlock Holmes about it and make everything make sense in the blink of an eye.

Then the moment passed, and the fight issued out of him as easily as blood from a wound.

"There's a chance that I'm going to pass out soon," he murmured instead. "If I do, it's _normal._ If you call an ambulance or try to wake me up, I will disembowel you and feed your entrails to Wiggins' dog."

 _What._ Sherlock thought he was going to pass out? And that was _normal,_ for him? No. Fuck no. This was not normal, no matter what Sherlock said, and the moment this was over, John was scheduling him for an appointment with a specialist, no protests taken, the end, no arguments allowed. Hiding his gender was one thing, but this was a serious medical condition and if Sherlock wanted him to be his doctor, then John was going to act as his _doctor._

Part of John still thought it'd be best to take him to A&E right now.

"One hour," he said, holding up a finger for his friend to see. "You get one hour. If I can't wake you up then, then I'm taking you in."

Sherlock rolled his eyes, though it didn't come out looking like all that much, with his face still flushed and half-hidden under his arm. He said nothing, which was John's cue to force the glass of water into his free hand and then nudge Sherlock onto his side, as sitting up really did seem beyond him, and watch with a careful eye as he finally got something down.

He waited until his mouth was fully occupied, to add on his last decision.

"And when you feel a little better, we're going to have a talk, Sherlock."

Sherlock once again said nothing. He just lay there, drinking his mandated gulp of water in silence, and when John let him stop he slumped to his back and shivered back under his towels.

"Fine," he muttered. "...Fine."

He sounded resigned. Not gearing up for a Sherlockian strop. Not a lecture, not an argument, not a tantrum, not a fight. Not preparing to eviscerate John alive and turn him inside out and drop him on his head with his words alone.

He was expecting-

John wasn't exactly sure what.

But by that ice-cold, defeated look on his face, he didn't need to be Sherlock Holmes, to guess what exactly it was that he was afraid of.


	2. Chapter 2

**Notes for the Chapter:**

> I think Mycroft is actually slightly out of character in this chapter, which is mostly a transition- it seems the general consensus is that Mycroft doesn't have any conception of the premise of "privacy" regarding Sherlock, and will tell John whatever medical history he wants to know, without John even needing to ask. But about this, especially, I wanted to make him a bit more restrained.
> 
> Enjoy!!!

The answer was actually quite obvious.

His ever-dependent source of information whenever something went wrong, with Sherlock Holmes:

Sherlock Holmes' arsehole of a brother.

_Obviously._

* * *

_So Sherlock's a girl, then?_

Maybe it was rude. Maybe it wasn't fair- no, scratch that. He _knew_ it wasn't fair.

But you know what else wasn't fair? Walking in on his fucking friend having a fit on the floor and throwing a bombshell at his face all in one; _that_ wasn't bloody fair. John had license to send out a couple rude texts if he wanted to, and he especially had license to send them out to Mycroft.

The answering call came in less than thirty seconds, and felt like a slap in the face with every ring.

"Oh, hello, Myc-"

"Chromosomally, yes. Neurologically, no." Mycroft's voice was like ice, even tiny and rushed with static through the cheap speaker of his phone. "As you are a doctor, I'd hope to not need to explain the difference."

"No. No, you don't, but-"

"Then you know that Sherlock is not, as you say, _a girl."_ Mycroft stopped for a moment, making his deductions the way only a Holmes could. "Since you are not plying Sherlock with these ridiculous questions, I can only assume he is unavailable, and not well. Do you need me to run a search for him through the CCTV network? Or perhaps phone for an ambulance?"

"What? No, he's fine, I'm looking at him right now, he's- I just found him bleeding from the fucking-" John cut himself off, still staring at Sherlock, one bare foot just barely visible in the crack of the door. Unconscious, still, but fitfully so. Definitely not for long.

The swell of anger in his throat withered back down, and in its place grew a disquieted worry.

He looked... horrible.

Swallowing hard, John gathered up his takeout and shoved to his feet, jerking away from the sight. No. He couldn't afford to get sidetracked now. "I just found him on his _period,_ Mycroft," he hissed, "did you know that? Did you deduce that, too? Hell of a way to find out- although it looked more like he had the damn flu, I didn't know what I was supposed to do-"

"Is Sherlock all right?"

"He's... yes. No. Not really." He glanced back at the hallway again, half-expecting to find the detective on his feet out of nowhere and listening from just around the corner. He wasn't there, of course. John almost wished that he had been. "He's passed out, now. He promised it was normal, but he wasn't... that can't be _normal,_ Mycroft. I would've thought it was his appendix if he hadn't already had it out."

"It is normal, for Sherlock." Mycroft's tone was clipped and unwelcoming, almost hostile, and the pause he left between his words was downright chilly. "If you feel the need to stage a fit of righteous indignation, do tell me now. If I need to arrange for new living arrangements, then I'd like to be informed as soon as possible."

 _"What?_ What are you... oh, shut up. _Shut up,_ you sanctimonious prick. I _never_ said that." John clenched his fists and sucked in a breath; now, _now,_ he was angry. First Sherlock, and now Mycroft. "What is wrong with you two?! What have I ever done to make you think my first reaction would be to- _that?!"_

"Well. Your very first act upon finding out appears to have been to summon me via text message to wail about Sherlock being a girl. John."

"That's..."

_...exactly what I did._

He squeezed his eyes shut, covering his face with his hands. The reflexive anger ignited in his chest still burned, but now it quailed underneath a sense of shame. Mycroft was exactly right. That was exactly what he had done. He had known it wasn't fair even as he'd typed the message, he'd even had an inkling of how it would've made Sherlock feel to know he'd typed it at all. But he's still typed it. And then he'd sent it anyway.

Could he really be all that insulted now, when he'd taken about twenty minutes to fuck this up in what was probably _exactly_ what Sherlock had been so afraid of?

John breathed in deeply again, trying to shove the sick sense of guilt back down. Sitting here and feeling like this wasn't going to get anything done. He had to sit still and to think, to listen, to _really_ listen. Mycroft's presumption, Sherlock's lack of trust- it was insulting as all hell, yes, and _especially_ the former. But this wasn't about him. It was about Sherlock.

Like it or not, Sherlock probably had every reason in the world to be wary about just who exactly knew this secret.

Thinking back on it now- the way he'd been so insistent on keeping John out... and that horrible look on his face when he finally had snatched the towel away...

_This has to have happened to him before._

The realization crashed into him over the head and John sank backwards, covering his mouth. He had to will himself not to be sick. This wasn't the first time someone had found this out against his will, was it? Old acquaintances, colleagues... probably even old flatmates.

And by the look on Sherlock's face, none of them had reacted well.

"I'm... sorry." John kept his eyes shut, measuring out his breaths one at a time. Damn it, he had to do this right. "I shouldn't have worded it like that."

"No. You shouldn't have."

On second thought, as angry as Sherlock was going to be to find out he'd talked with Mycroft behind his back- it was probably best to have this conversation now. If he was going to have this initial screw-up, then it was best that he have it with Mycroft. He didn't care what Mycroft thought of him at all, but messing this up with Sherlock was not something that could happen. It absolutely _could not._

"I'm sorry," he said again. "But one of you still should've told me."

"Why? What business is it of yours?"

"What business- for starters, I'm his _doctor,_ Mycroft. I didn't even volunteer for it, he just put my name down and started treating the flat as an A&E, and you endorsed it, and neither of you thought I might need to know my patient's medical history! What about his medications? He has to be on testosterone, you never thought I should know that, to watch out for other drug interactions? I- I assume he's on testosterone, I don't actually have a clue, if he is this shouldn't have happened-"

"He is. I suspect that he simply skipped his last dose or two- that case in Switzerland," Mycroft explained, but his words were still tense, and he sounded like he didn't want to be on the phone at all. John's reaction was going to be under scrutiny, and he wasn't going to get a second chance. "He tends to leave his medication behind whenever he has to fly. The questions it raises when going through security are of a sort that he likes to avoid."

John sagged backwards again, still covering his mouth. Of course. _The flight._ Sherlock didn't fly often, he had no reason to, but the case in Switzerland had been a solid nine out of ten and Sherlock had been over the moon. Sherlock had stayed for three weeks, while John had flown back after just the first, needing to get back to the surgery while Sherlock had sniffed around fancy museums and flirted his way about a five star hotel and ordered coffee in Swiss.

Sherlock had been so wrapped up in the case, he probably hadn't even remembered he was supposed to be taking anything at all.

And John hadn't been able to remind him, because despite him being _Sherlock's doctor,_ nobody had ever thought to let him know.

After several moments, the politician went on again, still slickly smooth and aloof in that very Holmesian way. "This is all irrelevant, you understand." He sounded like he thought John was barely more intelligent than a goldfish."There aren't any medications you would be prescribing that would interact severely with Sherlock's, and there's not any emergency treatment you'd have been expected to give him that is dependent on his genitalia. You're angry because Sherlock kept this from you as this silly concept of friendship, not as your _patient._ But what you still fail to realise is that, patient or friend, it's as I've already said-"

"Are you a doctor? Is Sherlock a doctor? Do either of you actually know-"

"As I've _said,"_ Mycroft hissed again, "... _none_ of your _business."_

John snapped his mouth shut, seething. He wanted to shut Mycroft's arrogance up, because he _was_ right about this, damn it. He was justified in being angry about this! It was unethical and downright dangerous for them to expect him to take care of Sherlock without having all the facts! As stupidly smart as they both were, hadn't they realised that, hadn't they realised what could've happened? If something had gone wrong, if John had- had...

Casting about for some mythical catastrophe, however- what _might have_ happened as a consequence of this deception- only proved the bastard right.

If Sherlock had gotten seriously ill or critically injured, then perhaps it would've been important. But at that stage, John would've already taken him to hospital and passed his care off to a team of physicians best equipped to handle it. The sorts of things John did for him- stitching up cuts, flashing lights in his eyes for a concussion, listening to his lungs to make sure that knockout head cold wasn't turning into pneumonia...

_It's none of your business._

Mycroft was right.

John sat limply for several moments, his hand dangling limply between his legs. He no longer had any sort of stomach for cold Chinese takeaway.

He pushed to his feet, suddenly just unable to stop himself. Trying to be as quiet as he could, John slipped back through the flat, his stomach in knots and his heart racing a mile a minute.

Sherlock was still asleep. He almost looked peaceful, even- resting on his back underneath a long blanket of dressing gown, his head lolling to the side and his hair in his eyes. He was still clearly sick, but his fever had gone down, and instead of lying there tense and coiled up and stiff as a board, he'd finally gone slack.

It was just Sherlock.

 _This_ was _his_ Sherlock. The Sherlock that was his business; the Sherlock that he was trusted to take care of. The Sherlock who trusted him enough to let him see him like this and believe that John would do nothing with this vulnerability but take care of him.

"...John."

"I- yeah. Sorry." He coughed, clearing his throat, and let the door drift back shut, keeping his voice as low as possible. "Still here."

Mycroft said nothing for a beat, and John took the time to once again withdraw. He slipped away, all but tip-toeing back to the sofa and the remains of his takeaway, and Sherlock's brother sighed.

Maybe Mycroft had deduced the change in atmosphere over the phone. Maybe not. Whatever it was, his next words had gone soft, like that hostile knife had slid into warm butter instead- soft, but more than that, very, very tired.

This wasn't Sherlock's first rodeo, and it wasn't Mycroft's, either.

"Speaking purely on the medical front, and Sherlock's medical history. You don't have anything to be concerned about presently."

"He's unconscious on the bathroom floor, Mycroft, I think-"

"Sherlock has endometriosis."

"He... _oh."_

John closed his eyes again, sinking back into the cushions. The revelation washed over him bit by bit, slower but no less shattering than the one of earlier today.

He could really do with a stiff drink.

Endometriosis was a condition in which the uterine lining, the same lining that was supposed to shed and bleed every month, began to grow uncontrollably, spreading beyond the uterus. But the tissue stayed subject to the same hormonal cycle no matter where in the body it was, and every menstrual cycle caused the same swelling, inflammation, and even bleeding, in _all_ endometrial tissue- whether it was in the uterus or not.

It wasn't something that would put Sherlock's life in danger, or make him seriously ill. It wasn't cancer or something that would continue to progress to crippling him or an injury that would never heal. It could've been so much worse- though a pang of guilt stabbed in his stomach at the thought of Sherlock gasping in agony and John now being _relieved_ , because at least he had an explanation as to why, at least he knew it wasn't _worse_. It definitely didn't feel like that to Sherlock, but... _god,_ it could've been so much worse than it was.

As far as John understood it, it was just something he had to live with, like arthritis or asthma. Ironically enough, hormonal therapy to stop the female reproductive cycle entirely was probably the best treatment Sherlock could've had. It explained perfectly why John had never seen any sign of this until now.

As a GP, it wasn't something John diagnosed, only wrote referrals for, so he wasn't very familiar with the nitty gritty. But he did know that it was always a concern whenever a patient complained of debilitating pain, and from what little he'd seen, Sherlock damn well fit that bill. It hadn't even been just pain- John had honestly thought he had the flu.

Great. So now he had an explanation for why he'd come home to Sherlock vomiting his guts out. He was still coming to grips with Sherlock being transgender at all, and now this. "So he's going to be okay?" he asked, craning his neck to check. Sherlock was still nowhere to be seen. "This actually is... normal. For him."

"Yes. He's probably been in some non-trivial level of pain for days now. He'll likely also be feeling much better by tonight."

"Good. That's... that's very good." John again covered his face with his hands, willing himself to calm down. That was something at least, wasn't it? As confused and unhappy as John was, he certainly didn't want Sherlock to keep on feeling that badly. It was a huge relief to know the worst had already passed.

It also meant that John wasn't going to be able to put off his upcoming conversation with Sherlock for that much longer.

"All right," he said finally, smoothing a hand down his shirt. Discomfort still squirmed in his chest but it was muted, now, subdued by the simple, hard facts of the matter. "I've got a few more questions, if I'm supposed to still be his doctor, but-"

"Then you should ask Sherlock."

"Mycroft-"

"You already know everything of a medical necessity. Everything else that you could want to know isn't relevant."

"But I've still got questions-"

"No, you don't. You have personal curiosities. Personal curiosities that are, unless Sherlock decides otherwise- _none of your business."_

John glared at nothing, argument curling his tongue. Mycroft would kidnap him off the street, he'd surveil Sherlock within an inch of his life, he'd told John all about Sherlock's drug history without even asking if he wanted to hear it, but _now_ he clammed up and discovered privacy? _Really?_ When John was still supposed to be Sherlock's doctor, mind, but not even that mattered next to Mycroft Holmes' bloody power games...

He gritted his teeth again and kept silent.

John still had questions. All the questions in the world. And Sherlock had never once ever seemed to give a damn about privacy- but perhaps that was it; perhaps Sherlock _seemed_ that way to keep better hidden the secrets he _did_ have _,_ the secret John had just found out completely against his will. The secrets Mycroft was refusing to divulge to him right now.

Because they should be Sherlock's choice.

Maybe Sherlock would care, and maybe he wouldn't. Honestly, John was pretty sure he wouldn't, but- that wasn't the point.

The point was that this was Sherlock's history, and Sherlock's life, and- John's friend.

He remembered being irritated when Mycroft had sat him down, all those years ago with Sherlock's medical history- his redacted medical history, apparently- all as an elaborate excuse to tell him _Sherlock likes drugs, and I'm expecting you to keep him off them._ He remembered being feeling shocked and even a little betrayed, on his new friend's behalf, that Mycroft would go around spilling his baby brother's secrets and his past. And wasn't this much the same?

No. No, this was even worse. As Sherlock's doctor, John _did_ have to know his history with substance abuse. He had to know all of it in every detail. But he didn't have to know this.

If Sherlock decided he wanted him to know, then he would. And if he didn't, then- he was just going to have to live with that.

"...Okay. I'll- I'll talk to Sherlock in a bit. Yeah." He chewed on his lower lip, heart thudding in his chest. "...Mycroft..."

_I'm glad Sherlock has you looking out for him._

John snorted to himself, shaking his head. _God,_ no. He could only imagine what Sherlock would have to say about that. Mycroft would probably just hang up the phone.

It was the truth, though. For once- Mycroft wasn't all that bad of a brother.

"...thanks," he grunted. "For-. You know."

Mycroft said nothing at first, and over the phone like this, the silence was completely unreadable. It went on just long enough that John nearly started to exchange goodbyes, but then the politician sighed and in that noise John heard the first good will in this entire conversation.

"I suppose I should be thanking you as well. Not many people would respond to something like this all that favorably, John."

He didn't have to be Sherlock Holmes to hear what was left unsaid.

How many other former friends and ex-flatmates had found this secret out and _not_ reacted _favorably?_

How many had reacted a hell of a lot worse than a stupid and ill-thought out text message to Sherlock's brother?

He didn't need to ask. That was another question that was Sherlock's to answer, if he ever would. He wouldn't ask Mycroft, and he didn't need to.

He'd seen the answer already in the horrified look on Sherlock's face earlier that day.

"You don't have to thank me for that, Mycroft," John rasped, feeling somewhat ill. "Not for being Sherlock's friend, no matter- who he is. Seriously. Please don't."

'Yes, well." Mycroft paused at length, his breaths audible over the phone, and then, "Life doesn't tend to work out so kindly, John."

Mycroft hung up, and John was once again left sitting in silence, cold takeaway in his hands and an unconscious flatmate a room away.

He still didn't know what he was supposed to do.

But he was beginning to get a good idea.


	3. Chapter 3

**Notes for the Chapter:**

> And that's a wrap! Thank you to everyone who's read and interacted thus far!!! <3

Fifty-five minutes after he'd passed out, John finally heard his best friend stirring.

He stayed put, sitting peaceably in his chair, tilted just enough to have a view of the hallway. He didn't want to crowd Sherlock, and by doing so provoke the strop to end all strops and therefore the permanent end to this conversation. A physical examination was out of the question, so John just listened, instead. If Sherlock wouldn't allow him to look at him, then he'd just keep his ears open instead. Enough so to make sure that Sherlock was okay.

The sink turning on and off. The sounds of brushing teeth, Sherlock spitting, running the sink again. Rustling, whacks of towels, a grunt.

After no time at all, the door creaked open, and Sherlock emerged as a pale zombie.

He was hunched over, draped in his rumpled dressing gown and pajamas with his head down and arms wrapped miserably about his stomach. Every step was a dragged inch of exhaustion, heavy and slow with his feet barely even lifted off the floor. He looked like he'd wanted to just curl up back down in a heap on the floorboards.

He turned his back on the sitting room without looking up, padded off, and vanished into his room without a single word.

John winced.

He could hardly blame Sherlock. Not this time. In his shoes, John thought he probably would've done the same thing.

He decided to give Sherlock a few more minutes. From what he could hear, the worst of it had definitely passed; while he was still clearly unwell, it was no longer to the point of being seriously sick. Sherlock didn't need a doctor, anymore, he just needed to rest. Much more important that was allowing him to have at least a few moments of privacy.

After this afternoon, John figured it would be best if he let Sherlock collect himself and scrape back together some shreds of his composure, before _this_ conversation.

He gave it ten minutes, after it had sounded like Sherlock had finally settled, to make his move.

Sherlock had stretched himself out in his bed, flat on his back again but this time buried securely under his duvet. Dressed now, and sullen rather than out of his mind. He still looked washed out and pale, his skin still damp, but the worst had passed, and he now just looked hungover or grousing with a bad cold.

He lay there with his arm draped back over his face, and despite John's very audible approach, still had eyes only for his sleeve.

"Hey," John called quietly, unsure of what else to say. He gave his bedroom door a close-knuckled rap. "Feeling better?"

"Yes."

"...Scale of one to ten?"

Sherlock sighed, his nostrils flaring. "Five." His voice was still a low and wrecked chainsmoker's growl.

John's brow furrowed. "You said earlier that appendicitis was a six."

"It's different types of pain. Appendicitis wasn't tolerable. This is. I-" He sighed loudly, clearly annoyed, and dragged his eyes open just enough to glare at John. "I'm feeling much better. Don't try and convince me I'm not."

John held his hands up in mock surrender, allowing the point to drop. However he wanted to describe it, Sherlock clearly did feel much better. Patients in severe enough pain that it qualified as some sort of medical emergency did not calmly answer questions, make sarcastic quips, and huff and puff. Sherlock was still in pain, but the crisis had passed.

"Can I get you anything?" He sat down on the edge of the bed, watching Sherlock even if Sherlock wouldn't look at him. He _would_ treat this normally. They _would_ have this conversation. "Just this once, since I don't think I fancy watching you crawl to the kitchen. You should drink something, at least."

"...Water. _Room temperature._ If you absolutely insist. And saltines," Sherlock muttered, frowning. Medically speaking, he still looked absolutely horrible. He glanced sideways at John, not even bothering to lower his arm from his face, and his bleary eyes were wet and bloodshot and just _daring_ him to say something. "If you bring anything else, no matter how well-meaning, I _will_ throw up, and you _will_ clean it up. And if you try to lecture me on the importance of nutrition during my _special time_ I will _kill you_ in ways that are too unpleasant to speak aloud, and Lestrade will never be able to find the body."

"Yeah, yeah, all right, Your Highness. _All right."_ Not even John of one hour ago would've been stupid enough to do something as suicidal as that. He got back to his feet, smiling a bit uselessly down at the bundle of blankets. "Should've figured you weren't the type for chocolate ice cream and netflix..."

"What?"

"It's- never mind. Never mind." No, that was a bad idea. He held his hands up, waving Sherlock down as he headed back to the kitchen to quickly fetch the requested items. He nearly made a comparison to a pregnant wife as well, but thought better of it. At least Sherlock was eating.

The consultant ignored the glass of water, but the crackers ended up on his stomach, spilling crumbs and crinkling plastic. He inelegantly crammed in three at once, looking a cross between ravenous and miserable and completely ticked off, and John's amusement fell. It really wasn't all that funny.

Sherlock's icy glare slid away from John, fingers pattering on his stomach as the ticks of a clock. Seconds passed in complete silence save for the noise of Sherlock's chewing.

Now or never.

"Sherlock. I-"

"Don't."

"I just wanted-"

 _"No,"_ Sherlock said flatly, snatching his hand back. "There's nothing to talk about. We don't need to talk about this!" He jerked his head to turn firmly away, his eyes squeezed shut and his jaw clenched achingly tight. "I'd like to go back to sleep, John."

This was it, then.

If John caved, if John took the easy way out that Sherlock was offering- he could do it. He could hold up his hands and stand up and say, "Okay,", and this would never be brought up again. Sherlock would emerge from his room tomorrow or in a few days in one of his bespoke suits, pronouncing the game to be on, and that would be it. This was John's one opportunity, and if he gave Sherlock what he wanted, it would be his only opportunity. They would never talk about any of this again and everything would go back to how it had been before.

It was easy, yeah. It would be incredibly easy. For John.

He took a deep breath, and started again.

"You don't want to sleep. You only just woke up." He drummed his fingers on the side of the bed, willing Sherlock to look at him. "I wanted to apologise, actually."

"Fine." His voice was too fast, almost panicked, and he tried to squirm away again. "Apology accepted. Now go away."

"No, I mean... actually _apologise,_ Sherlock. I was trying to make sure you weren't seriously hurt and I stand by that, but- you should've been able to control how you wanted me to know. If... you ever did. I'm sorry I took the choice away from you."

Sherlock snorted, his face still turned away. "It hardly matters." His fingers played with the sheets again- that anxious habit of his, the inability to keep still. "If that's all, then-"

"Sherlock."

The look on his face- genuinely horrible. He couldn't meet John's eyes and his white fingers wouldn't sit still and he looked like he wanted to crawl out of his own skin. He really believed John wasn't going to react well. Sherlock _actually thought_ that today was going to end badly and was doing everything he could to postpone this conversation because he desperately didn't want to hear what John was going to say.

He took a deep breath, and started again.

"It's fine, Sherlock. Seriously- I mean that. It's _all fine."_ He'd tried to swallow back the insulted feeling, that Sherlock would ever think otherwise at all, but he just couldn't stop the initial sting from worming its way back in. "Really? Did you ever really think I wouldn't be okay with this?"

Sherlock looked away, staring very hard at the opposite wall. His jaw was clenched so tightly it could've ground glass. "Not many people are." He fidgeted again, clearly supremely uncomfortable. "It also was not particularly inspiring to learn that you were estranged from your gay sister."

"Hang on, that's-"

 _"I don't_ _want to talk about it."_

John sighed, his shoulders sagging. This wasn't what he'd wanted. This wasn't what he'd wanted at all.

Sherlock lapsed back into silence. He looked like he wanted to turn on his side, to burrow under his blankets and ball himself away, but he was in too much pain to do so and contented himself with glaring at the wall and seething instead. His face stayed shrouded and cold, and he looked so _miserable,_ but John knew he couldn't follow his lead into silence. It was not the right thing to do, to let this go.

He sat quietly, chewing on the inside of his cheek and determining his next move.

"I spoke to Mycroft-"

"I know. Obvious."

"...'Course it is." John hesitated again, resisting the urge to fix the edge of the duvet. Sherlock looked freezing, but trying to fix the blankets would probably get something thrown at him. "Is it obvious what we talked about?"

Sherlock hummed noncommittally. Still, he refused to look at John. His fingers drummed over his stomach in an ever-lengthening silence.

"I have endometriosis."

Unsure if this was a statement or answer, John just nodded. "Right."

Sherlock kept his gaze averted, picking on at stray threads. Clearly, he still did not want this conversation to continue.

Well? Fuck that.

He was Sherlock's doctor.

It was his _job_ to have this conversation with him, whether it made him uncomfortable or not.

"Even if you already have a diagnosis-"

"John."

"-you ought to make an appointment for another exam. I could write you a referral, if-"

_"John."_

"-look, even if you already got the tissue removed, some of it has clearly grown back, and-"

 _"John,"_ Sherlock groused, his voice lower the echo of a cello and one step away from the snarl of a panther cat. He covered his face with one long hand, squeezing the bridge of his nose in explicit annoyance. "There is absolutely no point in subjecting myself to it. It's only a problem if I slip on HRT, which, ignoring this aberration, I never do. Leave. It. Alone."

Well, that wasn't actually true. Medically speaking, it simply was not true. But John also hadn't been planning on pressing him about that. Not right now. But, if Sherlock was the one bringing it up... "Yeah, about that. You really should at least see an endocrinologist, Sherlock. Missing one or two doses shouldn't have been enough to cause this."

Sherlock groaned aloud, dragging his hand down his face. He looked like he wanted to just bury himself into a pillow and evaporate his entire existence.

Damn it, if he could at least not be a child about this. _"Sherlock-"_

"Yes, obviously not! I also shouldn't have just spent my entire afternoon wanting to kill myself, thrown up at the smell of your dreadful and ill-advised takeaway order, and I also _really_ should not currently be experiencing the sensation of a family of newborn rodents cutting their teeth inside me." He finally dropped his hand to glare daggers at the ceiling, pale and disgusted. "Clearly, nothing about me has ever worked as it should. I don't _care_ , John. And this is not something that we are ever going to discuss."

That was... a fair point, actually. Not one that necessarily satisfied him, but it did make some measure of sense. And John still wasn't done with this, but Sherlock's mind was clearly made up, and this part of the discussion was something that could wait. Now was certainly not the time to try and force it.

Sherlock was quiet for several moments again, the tension on his face fading as he realised further interrogation was not to come. His glassy eyes flickered away, cat-like and bloodshot, and his fingers still drumming an unsteady pattern on his stomach. "You called Mycroft."

"...Yes." Accusation glimmered in Sherlock's glare, but it took John a moment to figure out why. "I'm sorry. I had to talk to _someone,_ and I know you hate him, but he was the only person I could be sure already knew."

"I don't hate him. He's irritating and more of a pest than a mosquito, and the country at large would probably be better off without him, but I don't hate him." Sherlock closed his eyes again, just breathing. "I suppose I ought to thank you for not calling anyone else."

John rolled his eyes, not bothering to resist his smile at that one. He didn't feel the need to ask if Sherlock would ever be able to say such a thing to his brother himself, or if he was aware that _more of a pest than a mosquito_ was probably the kindest thing he'd ever said about Mycroft Holmes.

Another awkward silence passed. John swallowed hard, willing himself not to squirm. "So, um. Who else... knows, then? ...Mrs. Hudson?"

Which was- decidedly not where John had wanted this conversation to go. It was not helpful at all and stupidly counterproductive, and he had no idea how it had come out at all. But the topic had at least made Sherlock very marginally more relaxed than before, his mess of curls twitching in a faint nod, and that was enough for John to pursue it.

"We met before I transitioned. Apparently my personality was... distinctive enough that she still recognised me when, I found her in London. As she says, she's familiar with all sorts."

"Distinctive enough. Right. I'm sure that's the word." John had figured as much, knowing how far back Sherlock and Mrs. Hudson's history went, but he'd wanted to be sure. God, he couldn't even imagine what Sherlock must've been like, all the way back then. What he must've looked like, how much of a terrifying force of nature a teenage, desperately unhappy Sherlock Holmes would've been... John shuddered. He had his hands full enough with this Sherlock, thank you very much.

"Lestrade?"

"He knows some of it. I'm not sure how much." Sherlock went back to fiddling with the duvet, then began crumbling up another cracker. His eyes stayed distant and cold, averted away, and John hitched a leg a little more onto the bed. "He insisted on drug testing me before he'd let me properly consult, and wouldn't trust me unless he was in the room watching. I think I nearly made him pass out. He's found my testosterone on his ridiculous drugs busts, too." The consultant huffed under his breath, sounding unspeakably annoyed. "We've never discussed it, so I don't know what he thinks. I've given him more than enough to make a proper deduction, but given the how lost at sea he is without me, I don't have the slightest idea what conclusion he's drawn. I don't care."

Privately, John figured that somehow, the DI had _probably_ grasped a lot more than he'd let on. Like Mycroft, Lestrade had been eager and willing to make sure John had known Sherlock's history with substance abuse upon just _moving in,_ but also known to not tell him this.

Sherlock really had no idea how lucky he was, did he?

"Okay. Um- Mol-"

"For god's sake, John, are we to explore my entire address book? What does it _matter?!_ No, Molly doesn't _know!"_ His eyes flashing, Sherlock finally wormed upright, yanking away from John's hand and glaring at the water as if it had said something to personally offend him. He sipped at it, mouth twitching. "Moriarty does."

Alarm jabbed through him in an electric shock.

"What- _Moriarty?!_ As in... as in _Jim Moriarty?_ " No. _No,_ this wasn't happening. His brother and very old friends were one thing, but London's very own consulting criminal? _"_ Guy who held a gun to my head and nearly blew us both up, _that_ Moriarty! What the hell, Sherlock, are you sure?!"

"Mmm, yes. We had a whole conversation about it- he can be very polite, when he wants to be." Next to John's sudden and immediate alarm, Sherlock remained horrifyingly aloof, even flashing him another pale and wan grin with his eyes alive for the first time all day. "There's nothing to get worked up about, believe it or not. He's only interested in beating me on his own merits; to watch me fail at my own game. He wants me to lose to _him,_ not... society's prejudices." He paused for a moment more, somehow managing to look so _bored_ John wouldn't have been surprised to see him start twiddling his thumbs. He'd cared infinitely more about ordering John to Tesco's for tea than calmly discussing the way his sworn nemesis and London's most dangerous psychopath could tear apart his life. "It would just be so _boring_ to destroy me with something so serendipitous."

That was... pretty fucking alarming. And somehow, Moriarty finding it _boring_ was not at all the relief Sherlock had meant it as.

But it also made a horrible measure of sense. Moriarty had always been fascinated by Sherlock's mind. _That_ was the challenge, to him. Outting Sherlock would wreck his career and destroy his reputation. But that wasn't a _win,_ not to Moriarty. That was cheating.

Moriarty liked to win. He didn't like to cheat.

It still didn't sit right with John. The very idea of Jim Moriarty knowing something that could do easily be used to destroy Sherlock made him sick to his stomach.

But Moriarty already knew. Somehow. Whether he liked it or not, it was far too late to do anything at all about it.

"...Right, then," John forced out, nearly choking on the words. "If you're sure." He watched Sherlock's silence and guarded cocoon, silver eyes still turned away from him and his jaw clenched, and before he knew it was squeezing a blanketed lump that was probably his hand. He couldn't help himself.

His next question was probably very, very stupid. But once again, he couldn't help himself.

"Anderson?" he tried, forcibly casual. "Donovan?"

Sherlock's startled eyes flickered back up, widening infinitesimally. "Why would they-?" He watched John for a moment in open confusion, just that one moment.

Then his gaze turned to ice, and the look on his face was nothing short of murder.

"We're done talking about this."

"Sherlock?" Shit. _Shit._ "I didn't mean-"

"No! No, I will _not_ have this conversation!" Sherlock started to turn away, panting through his nose and clenched teeth, but then suddenly whipped back around to face John head on with eyes like fire. "What is it? It's perfectly all right for me to be a monster or a freak when it's just for my _brain_ and how it works, _who I am,_ John, but for something as inconsequential as my cock or lack thereof and _now_ it's suddenly not okay?!"

Oh, fuck. He'd screwed this up. That hadn't been what he'd meant at all, except now that he heard the words himself it _had been,_ just a little bit- that had been the worst thing to say, to even think, and he'd really offended him, hadn't he? John could see it right there on Sherlock's face. He'd had an hour to prepare and still barely managed to last ten minutes before taking the worst turn, facefirst right into a wall. "Sherlock-"

 _"No!"_ he shouted again. "This is _exactly_ why I never told you! _This,_ John, right here! You see me differently, now- you _treat me_ differently! I'm Sherlock Holmes, I am _a genius,_ I am an arrogant bastard freak of nature, because I am smarter than _all of you,_ I'm- I'm a _genius,_ John," he snapped again, breathless and enraged, his eyes burning and _alive,_ god, he was so _angry,_ "everything else is nothing more than meaningless transport- and yet the first thing you'll think when you look at me now is what's under my trousers! Just- _fuck off,_ John!"

"I'm sorry! I know I'm messing this up, that's not what I meant at all, but I'm _trying_ here, Sherlock! And I know it's not fair to ask you to be patient about this, but I'm doing all that I can- just give me the bloody chance to try!"

Sherlock shut his eyes again, huffing through his nose and looking furious, and John had to take a moment to just turn away and breathe. Yelling at each other wasn't going to get anywhere. He forced himself to remember the look on Sherlock's face, earlier this afternoon. To remember how silently _angry_ Mycroft had been at him on the phone.

This wasn't about him. This was about Sherlock's life- a secret John had found out without his permission, an one that Sherlock had never wanted him to know. As frustrated as John was, he couldn't lose sight of that.

He returned back to the side of the bed, finding Sherlock turned back away and unbearably sullen, glaring at the wall with half-lidded, angry eyes. John reached forward to gently touch the lump of blankets, but something about the look on his face made the impulse quail, and he pulled his hand back without ever touching him at all.

"I'm sorry," he repeated quietly. "I'm not... trying to treat you differently. Or I shouldn't be. I'm just trying to understand you a little better, I think. I'm certainly not going to pity you."

Sherlock's ashen face twisted; he still looked punched in the gut. "I should hope not."

 _"But_ ," John forged on, catching the edge of the lump with a firm hand, "I don't want to just ignore it, either. It's- obviously important to you. What kind of friend would I be if that I pretended today didn't happen at all?" He stopped, giving him a moment, but Sherlock's sullen expression only turned even more annoyed. "At the very least, it's something that I need to know about if you want me to keep being your doctor."

Sherlock all but pouted, looking incredibly put out, but at least no longer outright angry. "Everything's worked just fine until now," he pointed out, and John could do nothing but raise an eyebrow. Oh, sure. Everything had worked out just fine. That was why he had almost called an ambulance for Sherlock just this afternoon, yes, definitely.

For several moments, it remained quiet. Sherlock continued looking sulky and unhappy, his eyes veiled, but John's point had been made. At the very least, Sherlock now had to know that John wasn't going to react badly. Even though it still hurt a little bit that that had ever been a concern in the first place.

All he needed to do was wait, and listen.

"They found it when I was twenty-four," Sherlock sighed at length, his voice still impossibly low and flat. He stared distantly at the ceiling, far, far away from John and his room. "I went in for a hysterectomy. I woke up to find out I hadn't gotten one, and my surgeon absolutely ecstatic to inform me he was referring me to another specialist. He'd cut me open, found endometriosis and diseased tissue instead, and therein found the reason I wanted to _mutilate myself._ " His voice was a calm drawl, spectacularly unbothered, the words and his vacant expression dripping with condescension, and his fingers pattered up and down like he was playing an invisible xylophone. He looked absolutely fine with it. "He understood why I'd wanted to before, but I didn't have to do that anymore. I was sick, you see. Properly ill! With a documentable medical condition, and not some sort of mental disorder. Now, they'd be able to treat it! I'd be able to be a proper girl _._ Perhaps even still have children. ...he expected me to be thrilled."

This was Sherlock's retelling, and John had already decided to let him say it at his own pace, without pushing or interruption. But at that, he knew he had to say something. "That was a long time ago, you know." He risked squeezing Sherlock's fidgeting hand, trying to get him to sit still. That certainly explained why Sherlock had never gone for the procedure again. "He sounds like a prick. But things have progressed a lot, in just a few years. Between me and Mycroft, I'm sure we could find you a much better-"

"No."

"It could be worth-"

 _"No,_ John." He turned his head away, curling away even more to bury himself under the blankets with his back now to him, a sullen and annoyed little ball. "Believe it or not, I'm not dependent on medical intervention to be satisfied with who I am. Why the _hell_ would I want to dedicate the next months or years of my life to centering around the fact that no matter how much I _look_ like a man, in the eyes of most of the braindead masses, I'm still _not one?_ It won't change how I look. It won't change how people see me. I already went through it once and it didn't even _work,_ John." Sherlock stopped for a moment, his face grey and vacant. "Do you have any idea what it's like to have your entire life defined by something that you hate?"

John drew up short, his breath caught.

"I... no." He swallowed hard, feeling suddenly very discomforted. "I didn't think of it that way, I guess. I'm- sorry."

He hadn't. And he didn't have any idea what that was like.

But after spending most of his life running away from his drunk father and his drunker sister- the last several years in particular had mostly been spent pretending Harry did not exist, beyond an uncomfortable knot in his stomach whenever the subject came up-

Well, maybe he _could_ understand. Just a little bit.

Sherlock hardly looked mollified, but he didn't look further incensed, either. He just looked very, very tired, and after a moment curled even more away, all that was visible being a head of angry, frizzy curls. "It's not all as angst-ridden and heart-breaking a story as you're thinking, you know," he grumbled. "Daddy taught me how to tie a tie. I'm not entirely sure he hasn't deleted I wasn't born this way entirely. He... insisted on being involved, actually, though google would have sufficed just fine. Though I still had to wear a skirt to school."

"Public school?"

"Obviously," Sherlock sniffed; he could almost see the vicious eye roll. "Even that wasn't as bad as it could've been. It was only for a few years. Tedious. _Stupid._ " He paused again, pressing his face deeper into the pillow. "The first time I passed out, I was sixteen, and ruined Mummy's Christmas dinner. The nurse at A&E was very confused as to why my parents had brought me in, and said I needed to grow up and learn to deal with it. Like the _rest of us_. Mummy nearly had her fired."

"Good," John snapped savagely. "She should've been."

Sherlock's mouth twitched, and for the first time he looked something other than exhausted. His silver eyes flickered back to John, unreadable and cold for one long moment.

Then they lightened in amusement, and he finally won himself a hard-fought smile. "Perhaps." He paused again. "I did learn to deal with it. Mostly with heroin. And then cocaine, which isn't quite a traditional painkiller, but- the sustained activation of dopamine is more than satisfactory as a replacement sensation. It's transcendent, really."

"Mm. Yeah. And addictive. That part, too. The most addictive substance known to man, isn't that what the most recent studies show?"

"A doctor's addict is a bored genius of a user," Sherlock returned, rolling his eyes. He was clearly very unimpressed and not at all open to pursuing the subject, and returned to thumping his fingers on his stomach again instead, frowning at the ceiling. "The only reason a twenty-four year old drug addict was allowed to go in for reassignment surgery was because Mycroft, pillock though that he is, arranged it. Don't tell him I said that."

"What. That he's a pillock?"

"He is a pillock. He just also has his uses. His limited, upon very rare occasion, uses." He shook his head in a twitch of curls, still burrowed under his blanket. "I even had a boyfriend, once. In university- you can shut your mouth, John, it is not _that much_ of a shock. Victor."

John worked his jaw, again forcing himself to keep his mouth shut. Boyfriend. Not his area- except it had been, once.

And it clearly wasn't now.

Because this Victor... had ended badly? And in what way? It must have ended badly; Sherlock looked upon the very idea of romantic relationships with outright hostility. John had known him for years, and the closest he'd come to one was whatever the hell Irene Adler had been. And John was still a doctor, he knew the statistics, he knew how things could go _wrong,_ but as his own sickened rage started to swell up inside of him he had to catch himself short, because wasn't _this_ what Sherlock had been so worried about? For John to look at him and reduce everything that he was down to this?

Sherlock could read minds, even sick as a dog and curled up facefirst into a pillow, and the detective waggled a hand at him, his fingers long and dismissive. "Stop that. It's silly and unnecessary. Victor... didn't fully understand, no. And he did break up with me after he found out. But he wasn't violent or cruel. He stayed friends with me. He didn't even out me." Sherlock tucked his head deeper into the pillow, gone quiet, almost wondering. "Whatever sad story you've been telling yourself in your head is unwarranted. I really have been extraordinary lucky, John. As even someone of your limited mental faculties can undoubtedly see."

There was something unspeakably sad, about the way Sherlock said that. How mystified he was, by the fact that this Victor had chosen to treat him with at least one single scrap of human decency, like that wasn't something he had any right to _expect_ \- like John wouldn't have gone out right now to go track him down to smash his nose in had he dared to have treated Sherlock with _anything_ less. It wasn't that he was wrong, exactly... and maybe that was the problem.

Because he wasn't wrong.

It felt horrible to admit it. But John _knew_ the statistics, and Sherlock was right. He truly had been extremely lucky. He had been born into a wealthy, well-connected family, to get him access to treatment in a day and age when that was the only way to get it. He had had supportive... friends? Whatever Victor and Lestrade and Mrs. Hudson counted for, he had people who knew his secret and hadn't been violent or broken his trust. He had had a _supportive family_. That, in and of itself, was still horrifyingly uncommon. Sherlock really had been incredibly lucky.

Perhaps it was the resigned way that Sherlock said it. That Sherlock _knew_ he was lucky, and John knew it, too. How easy it would've been for his life to turn out so very differently, and how unfair that was. How unfair that it had to be termed _lucky,_ just because he had had something at all approaching healthy relationships with friends and family.

And John knew the story he'd gotten today was the glossed over and sanitized version. Sherlock could tell whatever version of the story he wanted to; like it or not, John was a doctor. He knew what the facts were. Sherlock was a transgender man that had been born in the 1980s.

There was a reason that Sherlock had been so alarmed when John had so stupidly yanked that towel away. There was a reason that Mycroft's first instinct had been, not to ask if Sherlock was okay, but to plan to get John as far away from his brother as possible.

Sherlock's story wasn't all rainbows.

John swallowed again, smothering down a knot of eye-burning rage. "Tea?" he asked, getting to his feet. "Or more water?"

The fluffy ball shrunk again, considering. His face was still completely hidden, and he didn't look like he was going to be coming out again any time soon. "Four sugars."

It wasn't his usual. Just this once, though, John figured he could forgo the lecture about his cholesterol.

He took his time in the kitchen, making two very careful cups of tea and then taking a moment to sip at his own. Three sips. Count to ten. _Do this right, John._

His return to Sherlock's bedroom found the blanket burrito sitting back upright, his knees pulled loosely to his chest. His face was visible now, only just, a sliver of pale, ashen skin that was still faintly flushed, his hair in a bedraggled muss and stood all up on end. He accepted the cup of tea, bringing it to his face and overflowing cocoon, and focused his quicksilver eyes on it and it only.

The interim silence, then, was John's opportunity to make his move.

"So." He sat carefully down on the side of the bed, brushing at the bundle of expensive sheets. "I'll let it drop, after today. But I do really think you should see a specialist, Sherlock. I'm sure Mycroft has a list of discreet ones, and just a simple blood-test or check-up can be much more illuminating than you might think, especially if something's wrong."

Sherlock sipped wordlessly at his tea.

"I'll consider it," he muttered finally.

John nodded back. "Thank you." He focused on his own tea, hoping to get Sherlock to understand. "Then, if, uh... that's what you want. That's the last we have to talk about any of this, then."

The detective's eyes flickered again, and he stiffened by degrees, the tea in his cup sloshing. He glanced at him speculatively, his gaze unreadable, and John could do nothing but look back and wait to pass his test.

Sherlock's life might've been lucky, up until now. He might be lying through his teeth, and hiding everything about it that hadn't been because he didn't want John to know. There were unquestionably things that had gone wrong and been cruel and unfair, even in what very little he'd told John here today.

All John was concerned about was how to make it better going forward.

_Do you have any idea what it's like to have your entire life defined by something that you hate?_

Then this couldn't define him going forward, either.

"That would be... yes. I-" His friend paused, his piercing, exotic eyes not looking away even once. "Thank you, John."

"Well. Not quite, actually. Sorry, but- as your doctor, I really think I have to-"

Sherlock started to pull away, his pale face transforming back into hostility. John caught his arm before he made it "Next time you fly, you're taking _all_ your medication with you. Even if I have to hide it in the bloody peanut butter, you got that? Because we're not repeating this afternoon ever again."

Sherlock blinked. His tired eyes remained dull and exhausted, but his mouth twitched again, just a little, and for the first time all day, he finally looked entirely put at ease.

"Deal," he said.

**Author's Note:**

> All feedback is welcome and appreciated!!! Thank you so much for reading, and stay healthy! <3
> 
> [Come say hi on tumblr!](https://problematic-ranowa.tumblr.com/)


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